Year-end checkup: 5 reasons to review your health insurance today
As 2025 winds down, most of us think about holidays or tax-saving investments. But one task deserves attention: reviewing your health insurance truly understanding it, not just confirming it exists.
- Dec 31, 2025,
- Updated Dec 31, 2025 2:57 PM IST
She hadn’t looked at her health insurance in three years. It renewed automatically. She thought she was covered. That belief held until last month, when her father needed an emergency angioplasty. The hospital bill came to ₹4.2 lakhs. His policy covered ₹3 lakhs. The rest? Out of the family’s savings. Sub-limits on certain procedures pushed expenses higher. “I thought we were covered,” Priya said, exhausted. “I just never actually checked what that meant.”
As 2025 winds down, most of us think about holidays or tax-saving investments. But one task deserves attention: reviewing your health insurance and truly understanding it, not just confirming it exists.
1. Your Sum Insured Hasn't Kept Pace
Medical inflation in India runs 10–14% annually. That ₹3 lakh policy that felt adequate in 2020 might barely cover three days of hospitalisation today. ICU costs, specialised surgeries, cancer treatments—all have climbed sharply.
Action: Check what major treatments cost in your city. Factor in chronic conditions and age. Consider ₹10–15 lakhs or more for metros. A top-up or super top-up policy can increase protection affordably.
2. Exclusions Can Blindside You
Knowing your sum insured isn’t enough. Policies come with exclusions—procedures, tests, or conditions that may not be covered. Waiting periods for common treatments like cataracts or joint replacements can be 2–4 years, even for healthy buyers.
Action: Pull out the actual policy document. Read exclusions and waiting periods. Call your insurer if anything is unclear. Confirm coverage before scheduling any procedure.
3. Pre-Existing Conditions Need Active Management
If you have diabetes, hypertension, thyroid issues, or other chronic conditions, complications during the waiting period may not be covered. Even after it ends, some policies cap coverage or exclude certain complications.
Action: Note when your waiting period ends. Confirm coverage in writing. Consider policies designed for chronic conditions—they’re more transparent and often more comprehensive.
4. Add-Ons Could Save Thousands
Base health policies often miss important gaps. Add-ons can cover critical illnesses, hospital cash benefits, sum-insured restoration, or consumables like syringes and gloves—costs hospitals often exclude.
Action: List scenarios that worry you: multiple hospitalisations, income loss, long-term treatment. Add the relevant riders. Most are affordable compared to potential out-of-pocket costs.
5. Your Family Situation Has Changed
Life evolves. Marriage, children, ageing parents, relocation, job changes—all shift healthcare needs. A family floater may no longer suffice. Group insurance may have ended when you left a job.
Action: Reassess everyone who needs coverage, update nominees, and adjust sum insured. Individual policies may suit families with seniors or young children better than one stretched floater.
The Real Cost of Not Reviewing
Policies bought years ago can feel “outdated” when healthcare, family, and costs have changed. Out-of-pocket expenses aren’t just financial—they bring stress, guilt, and tough trade-offs in treatment decisions.
Reviewing your health insurance now—before an emergency—means one less crisis later. It gives families the freedom to act quickly, focus on care, and avoid scrambling for funds when time and calm matter most.
Your Year-End Action Plan
- Gather all policy documents. Check sum insured, exclusions, waiting periods, and add-ons.
- Compare coverage against current healthcare costs in your city. Note expiring waiting periods.
- Call your insurer or broker. Confirm coverage details and scenarios.
- Update sum insured, add riders, revise nominees, or switch policies if gaps remain.
The best time to review insurance is before you need it. The second-best time is right now. Entering 2026 fully protected isn’t just smart financial planning. It’s one less worry in a world full of uncertainties and peace of mind may be the most valuable coverage of all.
(Views are personal; the author is CEO at BajajCapital Insurance Broking Ltd)
She hadn’t looked at her health insurance in three years. It renewed automatically. She thought she was covered. That belief held until last month, when her father needed an emergency angioplasty. The hospital bill came to ₹4.2 lakhs. His policy covered ₹3 lakhs. The rest? Out of the family’s savings. Sub-limits on certain procedures pushed expenses higher. “I thought we were covered,” Priya said, exhausted. “I just never actually checked what that meant.”
As 2025 winds down, most of us think about holidays or tax-saving investments. But one task deserves attention: reviewing your health insurance and truly understanding it, not just confirming it exists.
1. Your Sum Insured Hasn't Kept Pace
Medical inflation in India runs 10–14% annually. That ₹3 lakh policy that felt adequate in 2020 might barely cover three days of hospitalisation today. ICU costs, specialised surgeries, cancer treatments—all have climbed sharply.
Action: Check what major treatments cost in your city. Factor in chronic conditions and age. Consider ₹10–15 lakhs or more for metros. A top-up or super top-up policy can increase protection affordably.
2. Exclusions Can Blindside You
Knowing your sum insured isn’t enough. Policies come with exclusions—procedures, tests, or conditions that may not be covered. Waiting periods for common treatments like cataracts or joint replacements can be 2–4 years, even for healthy buyers.
Action: Pull out the actual policy document. Read exclusions and waiting periods. Call your insurer if anything is unclear. Confirm coverage before scheduling any procedure.
3. Pre-Existing Conditions Need Active Management
If you have diabetes, hypertension, thyroid issues, or other chronic conditions, complications during the waiting period may not be covered. Even after it ends, some policies cap coverage or exclude certain complications.
Action: Note when your waiting period ends. Confirm coverage in writing. Consider policies designed for chronic conditions—they’re more transparent and often more comprehensive.
4. Add-Ons Could Save Thousands
Base health policies often miss important gaps. Add-ons can cover critical illnesses, hospital cash benefits, sum-insured restoration, or consumables like syringes and gloves—costs hospitals often exclude.
Action: List scenarios that worry you: multiple hospitalisations, income loss, long-term treatment. Add the relevant riders. Most are affordable compared to potential out-of-pocket costs.
5. Your Family Situation Has Changed
Life evolves. Marriage, children, ageing parents, relocation, job changes—all shift healthcare needs. A family floater may no longer suffice. Group insurance may have ended when you left a job.
Action: Reassess everyone who needs coverage, update nominees, and adjust sum insured. Individual policies may suit families with seniors or young children better than one stretched floater.
The Real Cost of Not Reviewing
Policies bought years ago can feel “outdated” when healthcare, family, and costs have changed. Out-of-pocket expenses aren’t just financial—they bring stress, guilt, and tough trade-offs in treatment decisions.
Reviewing your health insurance now—before an emergency—means one less crisis later. It gives families the freedom to act quickly, focus on care, and avoid scrambling for funds when time and calm matter most.
Your Year-End Action Plan
- Gather all policy documents. Check sum insured, exclusions, waiting periods, and add-ons.
- Compare coverage against current healthcare costs in your city. Note expiring waiting periods.
- Call your insurer or broker. Confirm coverage details and scenarios.
- Update sum insured, add riders, revise nominees, or switch policies if gaps remain.
The best time to review insurance is before you need it. The second-best time is right now. Entering 2026 fully protected isn’t just smart financial planning. It’s one less worry in a world full of uncertainties and peace of mind may be the most valuable coverage of all.
(Views are personal; the author is CEO at BajajCapital Insurance Broking Ltd)